Method, system and apparatus for guiding and tracking medication usage

ABSTRACT

Methods and systems are provided for tracking and guiding a patient&#39;s clinically directed medication usage. Medicaments are placed in secure passive packaging that must be unlocked to enable dispensing of a dose or a set of doses. This packaging is designed to be difficult to open manually, and instead is designed to dispense only when used in combination with a smart key. The smart key is a separate device containing electronics, mechatronics or both, to unlock and dispense from the packaging and to track and guide usage. Together, the secure container and the smart key track medication usage, trigger reminders in accordance with actual patient data, deter an excessive rate of patient usage, and deter unauthorized access to medication.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.61/972,167, filed Mar. 28, 2014, the contents of which are incorporatedherein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention generally relates to the field of medicine. Inparticular, various embodiments relate to systems and methods forcontrolling access to medicaments.

2. Description of the Related Art

Many medications, especially drugs in pill form, are now regularlyself-administered under little or no supervision. Self-administration ofmedication raises the possibility that a patient will fail to complywith directions regarding aspects such as dosage and timing. It isestimated that less than 50% of written prescriptions are taken asprescribed. Non-compliance can greatly diminish the effectiveness of thetreatment as well as increase the likelihood of harm to the patient,neither being desirable. Further, non-compliance can increase healthcarecosts and consume healthcare resources that could be allocated elsewherebut for the non-compliance.

Non-compliance often occurs by simple mistake or neglect, particularlywhen the patient is required to self-administer a complex regimen ofmedications. In order for a medical professional to respond withcorrective action or to change the treatment regimen, it would bebeneficial for the medical professional to be made aware of thepatient's deviation from the prescribed usage. A co-related problem isthat during a doctor visit, the patient may not be able to accuratelyrelay medically relevant information about medicament usage and symptomsbecause the patient's previous actions, symptoms, and side effects arehighly susceptible to the vagaries of memory.

The patient's non-compliance with a prescribed medication regimen mayresult in underdosing, overdosing, medication abuse and dependency, allof which typically affect a patient's overall health and, in many cases,can be life threatening. Overuse of certain medications, such aspainkillers, has become a major societal concern. Healthcareprofessionals have no acceptable tools to detect abuse patterns, todeter misuse, to limit diversion, or to optimize patient education forat-risk patients.

Physical systems have been developed to restrain patient access tomedicaments to a prescribed pace, and involve the use of electronics andmechatronics in the dispensing device, components that can be relativelycostly. These previous approaches are useful only if each abuse-proneprescription is delivered to the patient within a secure,abuse-resistant device or package and so the dispensing device costs, orthe recycling of the dispensing device, must be included in everyprescription. Such costs can prove prohibitive. Even if the device costsare amortized over multiple prescriptions, recycling may involveshipping the dispensing device back to a central facility, and returnshipping costs alone can prove economically unviable if applied to everyprescription.

Many medication therapies can be complemented with multidisciplinaryhealthcare support in the form of adjunctive therapies. For example, anevidence-based treatment approach for various mental health andpain-related conditions is known as cognitive-behavioral therapy (CBT),which can be used in conjunction with prescribed medications. Even whenadjunctive therapies such as CBT are available, they are almost alwaysadministered independently from the medication treatment provided by apatient's physician. This independent treatment may have clinical goalsthat are incongruent to the goals of the referring physician and,furthermore, treatment progress and results may not be available to theprescribing physician in a reliable and frequent manner. An integratedcare approach to medical and relevant adjunctive health services wouldpreferably combine all treatments into a single treatment plan. However,structural healthcare barriers, such as problematicinter-multidisciplinary communications, geography, and the logisticalstruggle of coordinating care, have prevented optimal integration ofmedication therapy with adjunctive therapies.

Various embodiments of the invention described herein provide a solutionthat addresses one or more of the issues described above.

SUMMARY OF THE INVENTION

According to at least one embodiment, methods and systems are providedfor tracking and guiding a patient's clinically directed medicationusage. Medicaments are placed in secure containers that must be unlockedto enable dispensing of a dose or a set of doses. The containers neednot contain electronics or powered components, and hence can be maderelatively inexpensively. This “secure passive packaging” is designed tobe difficult to open manually, and instead is designed to dispense onlywhen used in combination with a “smart key”. The smart key may take theform of a separate device, implemented in various embodiments withelectronics, mechatronics or both, to unlock and dispense medicamentsfrom the dumb packaging and to track and guide usage. The securecontainer and/or smart key can be used to track medication usage,trigger reminders in accordance with actual patient data, deter anexcessive rate of patient usage, and deter unauthorized access tomedication. Moreover, embodiments of the invention can be interconnectedwith a master system that enables automatic and regular assessment ofpatients.

In various embodiments the smart key is able to communicate with othersystems to collect data indicative of patient health. For example, thesmart key could communicate with independent healthcare devices andcollect data values for the patient's blood pressure, glucose levels, orweight. In specific embodiments the smart key contains a touchscreen, orcan interact with external computing or telecommunications devices tointeract with the patient. Via these or other means, clinically relevantassessment questionnaires regarding the status of a patient's health canbe conducted by the system. These assessments can create a clinicallymeaningful timeline of symptoms, side-effects and activity levels.

Various embodiments allow the data gathered, both objective andsubjective, to be communicated to a master system. The master system cancombine data into actionable reports for use by healthcareprofessionals. The reports enable a healthcare professional to betterassess whether or not there is an apparent pattern of progress. Ifprogress is less than desired, the care team can then make anevidence-based decision on whether to proceed with the therapy,supplement the therapy approach, or change the therapy regimen.

Moreover, other embodiments enable intervention in an automatic orsemi-automatic manner to (a) curtail medication access when overuse isnoted, (b) generate reminders when underuse is detected, and (c)communicate educational messages at relevant times, based on thesubjective and objective data being gathered from the patient. Certainembodiments can include an integrated care system where psychologicaltherapies such as cognitive behavioral therapy (CBT) are tightlyintegrated with dispensary components that track and guide the patientthrough the clinically directed medication regimen. Such integrated careembodiments produce a therapy process that reduces the risks ofmedication misuse while optimizing patient outcomes as a result of thetherapy.

Although the various embodiments are described herein for use in ahealthcare setting, it will be appreciated that the invention is not solimited. Certain aspects of the invention may, for example, haveapplicability in other settings, such as the monitoring of cargo,valuable items, or the monitoring of devices controlled by users proneto undesirable behavior or error.

BRIEF DESCRIPTION OF THE FIGURES

The various aspects and embodiments disclosed herein will be betterunderstood when read in conjunction with the appended drawings, whereinlike reference numerals refer to like components. For the purposes ofillustrating aspects of the present application, there are shown in thedrawings certain preferred embodiments. It should be understood,however, that the application is not limited to the precise arrangement,structures, features, embodiments, aspects, and devices shown, and thearrangements, structures, features, embodiments, aspects and devicesshown may be used singularly or in combination with other arrangements,structures, features, embodiments, aspects and devices. The drawings arenot necessarily drawn to scale and are not in any way intended to limitthe scope of this invention, but are merely presented to clarifyillustrated embodiments of the invention. In these drawings:

FIG. 1 is a diagram of primary system components according to oneembodiment;

FIG. 2 is a flowchart showing an embodiment process for dispensingmedications with the system illustrated in FIG. 1;

FIG. 3 is a flowchart showing an embodiment process for unlocking anddispensing from an access-controlled medication container;

FIG. 4 is a cross-sectional view of an embodiment smart key;

FIG. 5 is a perspective view of an exemplary pill box;

FIG. 6 is a top view of an embodiment rotor;

FIG. 7 is a cross-sectional view of components of an embodiment pillbox;

FIG. 8 is a figure showing certain components of an exemplary pill box;

FIGS. 9 and 10 are perspective and top views of an embodiment rotorcomponent of an embodiment pill box;

FIG. 11 is a perspective, cross-sectional view of rotors of anembodiment pill box;

FIG. 12 is a bottom view of an embodiment top rotor;

FIG. 13 is an interior view from a top perspective of a bottom rotor andpossible positions of a connecting arm;

FIG. 14 is a perspective view of an alternative embodiment pill box;

FIG. 15 is a side view of the components of the pill box shown in FIG.14;

FIG. 16 is a top see-through view of components of the pill box shown inFIG. 14;

FIG. 17 is a perspective see-through view of the pill box shown in FIG.14;

FIG. 18 is another perspective see-through view of the pill box shown inFIG. 14;

FIG. 19 shows components of a therapy management system that leveragesembodiment smart key and pill box medication management technology inconjunction with psychological therapy;

FIG. 20 shows an alternate embodiment medicament dispensing system;

FIG. 21 shows the medicament dispensing system of FIG. 20 in a coupledstate;

FIG. 22 is an exploded view of a pill box shown in FIG. 20;

FIG. 23 is a cross-sectional view of the pill box shown in FIG. 20;

FIG. 24 is an internal view of the pill box shown in FIG. 20;

FIG. 25 is a detailed exploded view of the pill box shown in FIG. 20;

FIG. 26 is a detailed internal view of the pill box shown in FIG. 20;

FIG. 27 is an internal view of a smart key shown in FIG. 20;

FIG. 28 illustrates coupling of the smart key and pill box shown in FIG.20; and

FIG. 29 is a flow chart illustrating use of the system depicted in FIG.20.

DETAILED DESCRIPTION

Aspects of the invention are disclosed in the following description andrelated drawings directed to specific embodiments of the invention.Alternate embodiments may be devised without departing from the spiritor the scope of the invention. Additionally, well-known elements ofexemplary embodiments of the invention will not be described in detailor will be omitted so as not to obscure the relevant details of theinvention. Further, to facilitate an understanding of the descriptiondiscussion of several terms used herein follows.

The word “exemplary” is used herein to mean “serving as an example,instance, or illustration.” Any embodiment described herein as“exemplary” is not necessarily to be construed as preferred oradvantageous over other embodiments. Likewise, the term “embodiments ofthe invention” does not require that all embodiments of the inventioninclude the discussed feature, advantage or mode of operation.

Further, many embodiments are described in terms of sequences of actionsto be performed by, for example, elements of a computing device. It willbe recognized that various actions described herein can be performed byspecific circuits (e.g., application specific integrated circuits(ASICs)), by program instructions being executed by one or moreprocessors, or by a combination of both. Additionally, these sequencesof actions described herein can be considered to be embodied entirelywithin any form of computer readable storage medium having storedtherein a corresponding set of computer instructions that, uponexecution, would cause an associated processor to perform thefunctionality described herein. Thus, the various aspects of theinvention may be embodied in a number of different forms. In addition,for each of the embodiments described herein, the corresponding form ofany such embodiments may be described herein as, for example, “logicconfigured to” perform the described action.

FIG. 1 provides an overview of an exemplary dispensing and patientguidance system. Specialized medication containers 101, referred to aspill boxes 101, are designed to be resistant to manual opening by thepatient, and instead require an inconvenient or difficult process toopen and dispense a pill in an unauthorized fashion. An electronicand/or mechatronic smart key 102 is designed to conduct the openingprocess that is otherwise difficult or inconvenient for the patient toperform. In the exemplary embodiment, the smart key 102 contains anoptical reader, such as a digital camera component 103, and a motorizedshaft 104 for use in dispensing medication from pill boxes 101. Todispense medications, patients place the head of the unlocking shaft 104of the smart key 102 into an appropriate slot 105 of the pill boxcontainer 101 and then press a dispense button 106 on the smart key 102.This initiates a mechatronic process on the smart key 102 analogous tounlocking a combination lock. The successful completion of that processenables a certain quantity of medication to be removed from the pill boxcontainer 101. Each pill box 101 has a different combination that isobscured from the patient, thereby preventing patients from detectingthe combination or accessing their medication when unauthorized to doso.

When smart key 102 is seated on pill box 101, the camera 103 of smartkey 102 is focused on a window 107 in pill box 101 through which can beseen machine-readable indicia 601 on a top rotor 501 (shown in FIGS. 5and 6) of pill box 101. It will be appreciated that the term “window107” includes simply an opening in top cover 502, or an opening coveredwith a suitably transparent material, such as clear plastic. Thisindicia 601 can be barcodes, QR codes or the like, which can be decodedby the electronics of smart key 102, and smart key 102 logic thatcontrols that unlocking shaft 104 so that top rotor 501 is turnedthrough the necessary unlock process based on images from camera 103.Because smart key 102 is necessary for the opening process, it can beprogrammed to effectively control and guide the regimen. This makespossible clinically useful dispensing contingencies, such as limitingthe number of pills that can be dispensed within a given time period orrequiring patients to complete assessments or review educationalmaterials as a condition for ongoing access to their medication. Onceall the medications from a pill box 101 have been dispensed, pill box101 can be disposed of. Smart key 102 can be connected to a new pill box101 whenever desired, and can use its camera 103 to read indicia 601describing the medication contained within.

A master system 108, capable of computing functions such as storage,process management, and logical decision-making, can have a datacommunication connection with smart key 102, such as via a wired orwireless communication network. Master system 108 can be either local,for example on a personal smart phone/tablet or personal computer of theuser, or remote, for example on a server accessible via the Internet.The desired functions of master system 108 can also be divided betweenlocal and remote server systems, as is known in the art. Master system108 collects usage data from smart key 102, and may communicate rules tosmart key 102 that affect medication access and reminders. Master system108 can also deliver patient-tailored instructional, assessment, andeducational materials via any suitable communication means known in theart, such as: computer, phone, or via a display on smart key 102 itselfMaster system 108 can control the overall therapy process 109, datacollection and storage 110, and therapy decision points 111.

FIG. 2 illustrates the medication loading and dispensing process. Pillbox containers 101 are loaded in step 201 with medications and locked(such as via a one-way snap fit) prior to delivery in step 202 to thepatient. Each pill box 101 can be labeled in accordance with current FDAprescription guidelines. The exemplary pill box 101 must be unlocked viaa process, like a combination lock, but the patient does not know thecombination. To unlock and dispense, smart key 102 is mounted in step203 to pill box 101, for example via a snap-unsnap temporary connection.Smart key 102 is shaped such that when it is mounted on pill box 101 thepatient cannot observe the coded unlock positions being actuated by thesmart key 102, and hence cannot replicate the unlock process manually.When medication is desired, the patient effects this process via smartkey 102, for example by pressing a dispense button 106. Then in step 204the smart key 102 checks internal logic and rules stored in its memoryto determine if it is allowable for the patient to have access tofurther medication at this time. If so, smart key 102 begins the unlocksequence. Smart key 102 logs in its memory any dispensations that occur.After the patient has reached a defined limit of use for the medication,pill box 101 returns in step 205 to a locked position.

FIG. 3 illustrates the cryptographic unlock and dispense process of theexemplary smart key 102 and pill box 101. In step 301, smart key 102turns top rotor 501 at least three rotations clockwise, and thereaftercontinues the rotation until top rotor 501 reaches the position for thefirst number of a combination. Camera 103 of smart key 102 is used towatch machine-readable indicia 601 printed on top rotor 501, and thecomputing system of smart key 102 decodes these images to determine whenthe first position is reached, at which point a motor 410 driving shaft104 stops. In step 302, smart key 102 turns top rotor 501 one rotationcounterclockwise, continuing thereafter until it detects the secondcombination position via camera 103 and indicia 601 and then stops. Instep 303, smart key 102 turns top rotor 501 clockwise until thecamera/image system 103 detects indicia 601 on top rotor 501 thatsignifies the final combination position, at which point a dispensingdrive train is engaged between top rotor 501 and a dispensing systemthat is used to dispense the medication from the pill box 101. At thatpoint, motor 410 can turn top rotor 501 clockwise again to dispense theallowed quantity of medication. In step 304, top rotor 501 reaches alimit of motion, which coincides with a limit of medication access forthat dispensing event, at which point motor 410 and top rotor 501 arereversed to disengage top rotor 501 from the underlying drive train,which effectively puts the pill box 101 back into a locked state.

FIG. 4 shows exemplary interior components of the exemplary smart key102. A computing system 401 includes a processor, memory, storage, abattery power system, and a wireless subsystem communicating over any ofa number of multiple wireless protocols or systems. The computing system401 can also include other components known in the art of mobile orfixed computing systems. Collectively, these components form a computingsystem 401 which can communicate with sensors and drive and controlmechatronic components. The exemplary smart key 102 uses a single boardcomputer (SBC) as the computing system 401, which in the exemplaryembodiment is a Raspberry Pi system. The SBC 401 also controls a smallDC motor 410 with a gear train 411 and receives input from apotentiometer 412, and the motorized system has an external shaft 104 onwhich is mounted a head 414 which can fit into and rotate top rotor 501on pill box 101 container. Computing system 401 is also optionallyconnected to sensors which detect when smart key 102 has been properlyconnected to a pill box 101 container, such as micro-switches,opto-switches or the like. SBC 401 also takes input from camera 103,which can be assisted by lights 416 mounted nearby. In the exemplaryembodiment 102, SBC 401 collects and processes images from camera 103.SBC 401 runs software that can recognize and decode machine-readableindicia 601 if visible in the captured image. When a smart key 102 isconnected to a pill box 101, smart key 102 will attempt to read barcodes601 or the like on top rotor 501 of pill box container 101 via window107. Computing system 401 can control motor 410 to rotate a pill box 101rotor 501, which will bring different barcodes 601 into view for camera103 as rotor 501 revolves. The control logic of SBC 401 uses input frompotentiometer 412 to deduce the position of motor 410, and usesmachine-readable indicia 601 to confirm the position to which motor 410has moved top rotor 501.

Users are informed of the state of smart key 102 via LEDs or a screenprovided on smart key 102. SBC 401 can further include supportingcircuitry for relaying signals between SBC 401 and other systemcomponents. This circuitry can include subsystems such as an H-bridgeconnected to motor 410 and allowing motor 410 to be rotated in eitherdirection. And SBC 401 is also preferably connected to a subsystemincluding an analog-to-digital converter connected to potentiometer 412,which is in turn connected to motor shaft 104, so that smart key 102control software can be aware of the position of shaft 104 or motor 410and send control signals accordingly to drive motor 410 in a desiredmanner.

SBC 401 optionally includes subsystems for wireless communications. Thiscan include technology for short-range or long-range wirelesscommunication with other system components, including support forstandards known to those in the art of mobile computing, includingBluetooth, Wifi, or cellular data protocols, such as 2G, 3G, 4G, LTE,etc. Optionally, SBC 401 can be connected, directly or via a wiredprotocol, to an electronic screen and/or input device to communicateinformation to the user or accept input from the user.

Variations on the exemplary smart key 102 embodiment can includes thosethat have multiple motors 410 and corresponding drive shafts 104 andmultiple cameras 103, features which may be used to unlock variations ofthe exemplary pill box. Cameras 103 can be optionally complemented bylighting systems 416, such as ultraviolet (UV) lighting components sothat the camera 103 can view images that are not visible to the nakedeye.

Smart key 102 preferably logs each time it is used to unlock a pill box101. Because smart key 102 contains a computing system 401, it can beprogrammed to provide or not provide additional access to medicationaccording to a set of dispensing rules crossed-referenced withdispensing data stored in its memory. For example, the dispensing rulescan include a minimum duration between dosages of the medication, andthus a minimum duration between successive unlock operations. Smart key102 can also communicate with master system 108 to communicate activityand receive updates to its operating and/or dispensing rules. Pill boxcontainers 101 can be disposed of when empty. The ability to constructpill box 101 containers out of materials of relatively low costs is asignificant advantage of various embodiments of the invention.

The exterior of exemplary pill box 101 is shown in FIG. 5. Top rotor501, a disc shaped object, is sandwiched underneath a top cover 502 andcan rotate freely thereunder. Top rotor 501 has machine-readable indicia601 (shown in FIG. 6), such as 2D barcodes, printed on it in aring-shaped pattern, and each indicia 601 can be selectively madevisible through window 107 (which includes clear sections) of top cover502. Indicia 601 can be printed using UV material so that they are notvisible to the naked eye, but can be visible to a smart key 102appropriately configured with UV lights 416 and/or sensors. The centerof top rotor 501 has a slot 105 into which shaft head 414 from smart key102 can enter to turn top rotor 501.

FIG. 6 shows top rotor 501 alone from above, with the positions ofindicia 601 radially outward from each hash mark and therefore visiblethrough window 107 of top cover 502 as top rotor 501 spins.

FIG. 7 shows a cross-section of selected components of the exemplarypill box 101. Top rotor 501 can be seen in profile, including indent 105for smart key 102 shaft head 414. Visible is a bottom rotor 701, theshaft 702 of which serves as a support and pivot for top rotor 501. Thetop rotor 501 is not directly, fixedly connected to the bottom rotor701, and rotation of the top rotor 501 would not necessarily createrotation of the bottom rotor 701 directly. Intermediate components,shown in subsequent figures, facilitate interconnection between top 501and bottom 701 rotors when pill box 101 is unlocked by smart key 102.

Bottom rotor 701 is connected downward to a drive plate 703 that has adrive peg 704 which can engage with a mating surface 705 of a top pillcarousel 706 to turn top pill carousel 706 forward. This pill carousel706, and each pill carousel 709 below pill carousel 706, can have adrive peg 707 that in turn can mate with and drive the next carousel 709below. In the initial position, drive plate 703 and its drive peg 704are engaged with carousel 706 and can advance it. As it does so, pillsfrom within each well in the carousel 706 can fall down an open shaft inthe carousels 706, 709 and out an exit slot 708. Once the top carousel706 is advanced a full rotation, its drive peg 704 picks up the nextcarousel down 709, and rotates that carousel 709 to dispense its pillswithin the corresponding wells. The pill box 101 can be designed withvarious numbers of carousels 709. The medications are sealed in the pillbox 101 by a seal 710 between the bottom rotor 701 and the drive plate703, and a separate cap or plug (not shown) to cover the exit slot 708.

The unlocking process occurs when rotation of top rotor 501 istemporarily connected to rotate bottom rotor 701. FIG. 8 shows aconnecting arm 801 which can fit into slots on top rotor 501 and bottomrotor 701 to bind the rotation of one to the other. When pill box 101 islocked, this connecting arm 801 is fenced away from the slots byintermediate rotors 901 shown in FIGS. 9 and 10. These intermediaterotors 901 have drive pegs 902 and 903 on each side, to allow them tocollide with and be pushed rotationally from the rotor 901 above, andhave a slot 904 sized for the connecting arm 801. FIG. 11 shows across-section of the rotor stack, including the intermediate rotors 901.The unlock process described previously allows the top rotor 501 tosequentially push each rotor 901, 701 into a position. To unlock thedevice, each rotor 501, 701, 901 is moved so that the slots 904 alignwith the connecting arm 801, which has a spring 1101 that pushes the arm801 radially inward and into the slots 904, 1203. FIG. 11 shows thestate where the slots 904, 1203 of all rotors 501, 701, 901 have beenaligned and the connecting arm 801 has sprung inward. Only then willrotational movement of the top rotor 501 be transmitted to the bottomrotor 701, and in turn through to the carousels 706, 709 holding pillsbelow. FIG. 12 shows the underside of top rotor 501, which has a drivepeg 1201 and a ridge 1202 that forces the connecting arm 801 out untilthe slot 1203 is aligned with arm 801. Once connecting arm 801 is inslot 1203, reversal of the top rotor 501 will force the ramp ridge 1204to drive connecting arm 801 back out of the slot 1203, effectivelycreating again a locked state for pill box 101.

FIG. 13 shows from above the positions that connecting arm 801 goesthrough. Position one 1301 is the default locked position, defined by acorresponding barrier, where the connecting arm 801 is pushed out bymisalignment of the rotor slots 904, 1203. Slot alignment allows spring1101 to push connecting arm 801 into position two 1302. Advancement ofthe top rotor 501 then pushes arm 801 to position three 1303. Furtheradvancement is constrained by another barrier 1305. Position four 1304is achieved when top rotor 501 reverses, and spring 1101 action thenpulls connecting arm 801 back to position one 1301. The sequence tounlock and advance the bottom rotor 701 can then be repeated by smartkey 102. It will be appreciated that the circumferential distance fromposition one defined by the first barrier 1301 and position threedefined by the second barrier 1305 can be used to set the number ofunits of pills that are dispensed, as this correspondingly determinesthe distance traveled by carousels 706, 709.

An alternate embodiment of a pill box is shown in FIGS. 14 through 17.FIG. 14 shows a top housing 1401 containing a rotating top wheel 1402,which in turn houses two rotors 1403 that can be partially seen viadrive holes 1404 in top wheel 1402, and via respective view windows1405. Rotors 1403 each have a central well and inward facing sprockets1406, such that a smart key configured with two motors and correspondingmating drive heads can turn each rotor 1403 independently andsimultaneously. An exemplary smart key 1407 has two drive shafts 1408that can be inserted through holes 1404 to engage with correspondingrotor sprockets 1406, and each drive shaft 1408 is connected to arespective motor 1409 and controlling electronics 1410 analogous to thatof the smart key 102 shown in FIG. 4. Each view window 1405 allows smartkey 1407 camera 1411 to watch a corresponding surface 1412 visible onthe rotors 1403 through view windows 1405. These rotors 1403 are labeledwith machine-readable indicia that are readable by smart key 1407 cameraor cameras 1411 and underlying processing logic, and in the exemplaryembodiment the labels are 2D barcodes printed using UV ink on thesurfaces 1412 in a circular ring on the top of each rotor 1403. Thesmart key 1407 of this embodiment operates analogous to that of theprevious embodiment described, in that a processor turns rotors 1403 tothe appropriate positions to enable unlocking of the pill box anddispensing of medications from a carousel 1413 through an exit slot1414. Carousel 1413 is sealed within top housing 1401 and a bottomhousing 1415. The motors 1409 can be programmed to move rotors 1403 to arespective specific angular position. The smart key 1407 can confirmrotor 1403 position by reading the machine-readable indicia on top ofthe rotors 1403 via respective windows 1405.

FIG. 15 shows a cross-section of the pill box shown in FIG. 14, showingthat rotors 1403 are held by the top wheel 1402 and a bottom wheel 1501,which are connected together via screws or other connecting means 1502to form a chassis for rotors 1403. Bottom wheel 1501 is molded tocontain a spur gear structure 1503 facing downwards. Other componentsshown are top housing 1401, carousel 1413, bottom housing 1415, and exithole 1414.

FIG. 16 shows a bottom view with bottom housing 1415 and carousel 1413shown transparent. Spur gear structure 1503 interfaces with a planetarygear structure 1601 molded into carousel 1413, assuring that turning ofthe top/bottom wheels will turn carousel 1413, which in turn will enableaccess to medications in carousel 1413. Carousel 1413 has wells 1602into which medication is placed. Once filled with medication, carousel1413 is placed in bottom housing 1415. Top housing 1401 is placed overbottom housing 1415 and snap fit formations hold top and bottom togetherin a manner that does not permit for manual disassembly. The only meansof removing pills is through exit hole 1414 in top housing 1401 whichreveals one carousel well 1602 at a time. Carousel 1413 is geared intothe top wheel 1402 via its attachment to the bottom wheel 1501, its spurgear 1503, and the carousel planetary gear 1601. Top wheel 1402 will notadvance unless the rotors 1403 are positioned properly.

FIG. 17 is a top view with top housing 1401 and top wheel 1402 showntransparent. The rotation of the assembly formed by top/bottom wheelsand rotors can be blocked by pegs 1701 that protrude from top housing1401 to collide with rotors 1403. When rotors 1403 are set to a specificposition by smart key 1407, voided space 1702 on the underside of eachrotor 1403 is lined up with pegs 1701 and allows the entire subassemblyto rotate past pegs 1701. When rotors 1403 are properly aligned, theuser can twist the smart key 1407 to advance top wheel 1402 forward, forexample, 90 degrees until being stopped by another set of pegs 1701, andthis forward rotation also rotates forward carousel 1413 by one well1602, as determined by gearing of sprocket 1503, allowing the nextmedication dose to advance underneath the hole 1414. The smart key 1407can use machine-readable indicia 1703, such as barcodes, printed on thetop surface 1412 of rotors 1403 and visible through windows 1405 toconfirm proper alignment of rotors 1403. FIG. 18 provides anothertransparent view of the components of this exemplary pill box.

FIG. 19 depicts a treatment system provided by the exemplary embodimentsof the pill box containers and smart key. The exemplary treatment systemintegrates the medication access control and monitoring technologydescribed herein with psychological therapy and support. The exemplarytreatment approach is for pain management, but one of ordinary skill inthe art could create similar programs for other treatment domains, suchas ADHD, depression, etc.

A patient-accessible computing device 1901, e.g. a smartphone, tablet orcomputer, is designed to run an application 1902 that serves as a MobileElectronic Diary for Treatment (MED-T). The patient computing device1901 has a communication path 1903 with an embodiment smart key. Thepatient computing device 1901 can be the same master system 108 shown inFIG. 1, for example, and the application 1902 may be considered acomponent and extension of that system 108. The MED-T application 1902enables users to track and report symptoms, emotions, and behaviors inreal-time, facilitate easy access to interventional content in vivo, andmanage prescribed medication regimens.

Treatment events depicted in reports can include scaled summary scoresof outcomes, pain, functioning, side effects, length/quality of sleep,medication problems, and adherence. The patient's status can be used todetermine their access to medications, enforced dynamically because thesmart key can control access to medications. In turn, the smart key canprovide accurate tracking of medication usage data that can be used topersonalize the treatment approach. Together these capabilities worksynergistically to motivate a patient towards proper behavior, and deterthe patient from undesirable behavior.

FIGS. 20-29 illustrate yet another embodiment of a medicament dispensingsystem. The system includes a pill box 2001 that is provided to apatient in the form of a locked and sealed container and into which apharmacist can deposit up to, for example, twenty doses of medication.The system further includes a smart key 2002, which is an electronicdevice that can be used by the patient to unlock pill box 2001 at theappropriate times to allow the patient access to a dose of medication.Each smart key 2002 can be used with multiple pill boxes 2001, allowingthe patient to use a single smart key 2002 for all of their medicationaccess.

As illustrated in FIG. 21, to utilize the medicament dispensing system,the patient simply places smart key 2002 on pill box 2001. To obtain adose of the medication contained within pill box 2001, the patientrotates smart key 2002 one-quarter turn, for example, which causes pillbox 2001 access window 2211 to align with a new pill carousel space2203. When no dose is required, smart key 2002 can indicate this in anysuitable manner, such as with an LED indicator, a screen readout, asound, etc.

As shown in FIG. 22, which provides an exploded view of the componentsof the exemplary pillbox 2001, the medication is stored in a rotatingcarousel 2202 inside a durable, sealed housing provided by a bottomcover 2201 and top cover 2205. Bottom cover 2201 and top cover 2205 canbe provided in a disassembled state along with carousel 2203, and caninclude respective snap fittings such that when the covers 2201, 2205are brought together, they mechanically engage with each other andcannot thereafter be separated, with the carousel 2202 then rotatablysandwiched between the covers 2202, 2205.

A wheel assembly comprising a top wheel 2210 and bottom wheel 2207 ontop housing 2205 interfaces with smart key 2002 above and carousel 2202below such that when smart key 2002 unlocks rotors 2209 in the wheelassembly and is rotated, for example, 90 degrees, carousel 2202 belowadvances one dosage slot 2203. Medication doses may be accessed throughan opening under door 2211 on top housing 2205, which can be sealedagainst moisture with an elastomeric (e.g., rubberized) door.

Pill box 2001 is used to lock pills or other types of medication insidetop housing 2205 and bottom housing 2201 unless smart key 2002 unlockspill box 2001. Preferably, pill box 2001 allows access to only a singledose of medication at a time, for example, by allowing access to only asingle dosage slot 2203 at a time. Pill box 2001 also preferably sealsthe pills against moisture and is designed so at to be easily filled andassembled by a pharmacist.

As illustrated in FIGS. 22-24, pill box 2001 includes a bottom cover2201 that houses carousel 2202 and provides a base of the pill boxassembly 2001. Carousel 2202 nests inside bottom cover 2201 and has, forexample, twenty individual slots 2203 for storing a single dosage ofmedication. Carousel 2201 has a hole in the center with an internal gearring 2204 around the periphery of the hole to rotate carousel 2201.

A top cover 2205 seals against bottom cover 2201 and covers carousel2202. A door 2211 in top cover 2205 is preferably the same size as asingle carousel slot 2203, and aligns with one slot 2203 at a time. Aspur gear 2206 is mounted inside top cover 2205 and engages internalgear ring 2204 of carousel 2202. Spur gear 2206 is mounted to a post ona bottom axis of wheel 2207, with the post passing through top cover2205 so that spur gear 2206 rotates whenever bottom wheel 2207 isrotated.

Bottom wheel 2207 rests on top of top cover 2205 and is surrounded by,and rotates within, a thin cylindrical wall 2208 protruding upward fromtop cover 2205. Two rotors 2209 are rotatably mounted onto bottom wheel2207. As shown in FIG. 24, each rotor 2209 includes a core 2401 and anouter ring 2402, which as an assembly are rotatably mounted on to bottomwheel 2207. The rotor outer rings 2402 each have a single involute notch2403 along an exterior edge which interlocks with corresponding engagingteeth 2404 on the interior of cylindrical wall 2208 of top cover 2205when properly aligned. However, when notches 2403 are not aligned withengaging teeth 2404, rotors 2209 prevent bottom wheel 2207 from rotatinginside top cover 2205, and thus prevent the rotation of spur gear 2206and any corresponding interaction with carousel 2202.

As shown in FIG. 25, underneath each rotor 2209 is a spring 2501 thatrotates rotor core 2401 and outer ring 2402 back to a home or restingposition after use. A respective post on rotor ring 2402 and a post 2502on bottom wheel 2207 are in contact with spring 2501 to ensure that theresting position of every rotor core 2401 is always the same. Theunlocking process requires rotating the rotor 2209 from this homeposition to a position in which the notch 2403 and engaging teeth 2404can engage. The outer ring 2402 can be placed in various positionsrelative to the rotor core 2401, by way of any suitable interlockingstructure, such as teeth, and thus different unlocking processes can beprovided that require different amounts of rotation for each position ofthe outer core 2401. For example, the outer ring 2402 can be placed onthe inner core 2401 such that the notch is near post 2502 that creates aresting position for the inner core 2401, or the outer ring 2402 can beplaced on the inner core 2401 such that the notch is rotationallydistant from post 2502.

In order to prevent improper medication access, carousel 2202 preferablyexposes only one new dose at a time. As shown in FIG. 26, carousel 2202rotates within bottom cover 2201, and is rotated by interaction withspur gear 2206 attached to bottom wheel assembly 2207. To prevent thefree rotation of carousel 2202, bottom wheel assembly 2207 fits into topcover 2205 and contains the two rotors 2209 which stop against engagingteeth 2404 inside cylindrical wall 2208 of top cover 2205. The teeth2404 in top cover wall 2208 are in, for example, four equal-distantpositions around the inside perimeter of wall 2208, so that bottom wheel2207 stops every ninety degrees of rotation. Carousel 2202 inner gearring 2204 has, for example, fifty teeth while spur gear 2206 has tenteeth, so that each complete turn of spur gear 2206 corresponds tocarousel 2202 rotating one-fifth of a complete turn, while a one-quarterturn of spur gear 2206 rotates carousel 2202 by one-twentieth of acomplete turn. It will be appreciated that with twenty dosage slots incarousel 2202, this means that a one-quarter turn of the wheel assembly,and the attached spur gear, results in the advancement of the carouselby one single medication slot 2203. It will be further appreciated thatthe relative gearing between spur gear 2206 and inner gear ring 2204 canbe changed to accommodate different numbers of slots 2203, to change thenumber of slots 2203 that are dispensed with each dispensing cycle, orboth.

On top of the two rotors 2209 is a top wheel 2210, which covers therotor mechanism 2207, 2209 from view and from tampering, as well asproviding a surface for interacting with smart key 2002 to lock intoplace on pill box 2001 and rotate the wheel assembly 2210, 2207 relativeto top cover 2205. Top wheel 2210 includes two openings respectivelycorresponding to rotors 2209 to permit rotation of rotors 2209 viaengagement with axles of cores 2401. If a rotor 2209 is rotated so thatthe next engaging tooth 2404 will fit into the rotor notch 2403 insteadof creating interference, the rotor 2209 is then in the unlockedposition, and the rotor 2209 will catch the tooth 2404 and rotate pastit without restriction. Both rotors 2209 must be in an unlocked positionfor the top and bottom wheels 2207, 2210 to rotate past a pair ofengaging teeth 2404 (which allows carousel 2202 to rotate to a new doseslot 2203). Smart key 2002 interlocks with mating components of pill box2001 and, with programmatic awareness of the position of each outer ring2402 in pill box 2001, mechanically rotates the rotors 2209 the correctamount to facilitate unlocking, i.e., advancement of the top and bottomwheels 2210, 2207. Twisting of the entire smart key 2002 by 90 degreesthen rotates carousel 2202 forward one slot 2203 and allows access to anew dose of medication.

The rotor outer rings 2402 can be placed in various positions on theinner cores 2401. Thus, once top wheel 2210 is in place and preventsvisible inspection of rotor 2209 positions, previous knowledge of theexact positioning of the rotor 2209 outer rings 2402 is necessary tofacilitate rapid alignment of rotors 2209 and thus advancement of thepill-carrying carousel 2202. Smart key 2002 preferably includesmechanisms and can be programmed with control logic to place rotors 2209into the unlocked position, such that only a patient in possession of avalid and activated smart key 2002 will have facilitated access to pillsin pill box 2001.

Door 2211 covers the access hole on top cover 2205 and seals thisopening. O-rings, gaskets, seals or the like can be provided forassembly and sealing of the components, as known in the art.

As shown in FIG. 27, smart key 2002 include a chassis 2701 that providesa base for smart key 2002 and that also mates to top wheel 2210 of pillbox 2001. Rotor drivers have a first end extending from underneathchassis 2701 with a raised mating pattern corresponding to a recessedpattern present on the pill box 2001 rotor cores 2401, interlocking andensuring simultaneous rotation between the mating components. Worm gears2702 and worm wheels 2703 transmit power to the rotors 2209 via therotor drivers. Micro-gearmotors 2704, which may include stepper motors,are mounted to chassis 2701 on, for example, limited-range swing armmounts, and power the gears 2702, 2703 for unlocking pill box 2001.Preferably, two potentiometers 2705 on opposite, second ends of therotor drivers provide feedback about the position of the rotors 2209. InFIG. 27 potentiometers 2705 are shown floating, however in preferredembodiments they are mounted to a microcontroller, circuit board or thelike.

A pair of fixed-distance optic sensors 2706 on, for example, adaughterboard can be mounted to the edge of chassis 2701 to providerotational position feedback to the smart key 2002 computing system,allowing smart key 2002 to determine the rotational distance of therotors 2209 from the teeth 2404 of the wall 2208, such as by monitoringchanges in height of wall 2208. It will be appreciated, however, thatany suitable rotational position detection system can be used forsensors 2706, including Hall-effect sensors, micro-switches, rotaryencoders and the like. Additional slot optic sensors 2707 can also beprovided to provide feedback about whether the smart key 2002 is inposition on pill box 2001, one positioned, for example, on the side ofthe chassis 2701 near the wedge shape 2711 and two on the flat edge ofthe semi-circle 2710. In this embodiment, a reader for machinereadable-indicia 2003 in the form of a barcode scanner 2708 and relatedlens are mounted on top of chassis 2701 wedge 2711, and read a barcodefrom top wheel 2210 of pill box 2001.

Smart key 2002 further includes a computing system 2709, which caninclude a microprocessor, data storage (including program code), a clockto track the date and time, and networking interface components, as wellas local interfaces with the barcode reading mechanism 2708, sensors2706, 2707, and the two motors 2704 to control rotation of the pill box2001 rotors 2209 when appropriate. The program code is executable by themicroprocessor to provide the overall desired functionality of smart key2002, as known in the art. The smart key 2002 barcode reader 2708 scansthe pill box 2001 to ascertain identification of that particular pillbox 2001. However, it will be appreciated that any other suitable methodand system may be employed to identify the pill box 2001 to the smartkey 2002. Once smart key 2002 has knowledge of the identity of pill box2001, computing system 2709 accesses a datastore (either locally ornetworked) to obtain or compute data about the unlock position of pillbox 2001 rotor set 2209. Once determined, computing system 2709 of smartkey 2002 can also access other data about the patient, treatment pillbox 2001 or both to determine whether to unlock pill box 2001 for thepatient to access a dose of medication. If access is authorized, a smartkey 2002 attached to a pill box 2001 as shown in FIG. 21 can thenposition the pill box 2001 rotors 2209 to facilitate unlocking of thepill box 2001. Then, with a quarter turn of smart key 2002, the new doseis ready to be accessed, and smart key 2002 shuts down. Smart key 2002may record in its data store information about the delivered dosage,such as date, time, amount, e.g., number of carousel spaces 2203dispensed, an identification of the pill box 2001, such as read from themachine-readable indicia 2003, or any other suitable information inresponse to delivering a dose of medication. This information can alsobe transmitted to a remote computing device by way of the networkinginterface components.

A cover, as shown in FIG. 20, provides interior mounting for a PCB ontowhich are mounted the computing system 2709, indicator lights or ascreen, and any other electronic components, as well as covering thesmart key 2002 components and providing a comfortable surface forgripping and turning.

Chassis 2701 of smart key 2002 snaps onto pill box 2001 as shown in FIG.28. FIG. 29 shows a state diagram describing the various states ofoperation for smart key 2002. Operating smart key 2002 can include thefollowing basic steps (if, for example, a dose is appropriate from thepill box 2001 at that time):

1. The user turns on smart key 2002 and places it on a pill box 2001.The smart key 2002 plastic snaps 2801 engage with pill box 2001.

2. Smart key 2002 uses barcode scanner 2708 to read machine-readableindicia 2003 on pill box 2001 and determines that a dose is necessary atthis time, based upon, for example, indicia 2003 that uniquelyidentifies pill box 2001, the date and time of a previous unlockoperation performed on the same pill box 2001 and dosage durationinformation (e.g., number of hours between dosages). The computingsystem 2709 uses the identifying indicia 2003 to determine therespective unlock positions of the rotors 2209, such as by a lookuptable based on the identifying indicia, performing a hash of indicia2003, or contacting a remote server. Once the unlock positions areobtained, the processor controls the motors 2704 to rotate rotors 2209to their respective unlock positions.

3. The user rotates smart key 2002 until it stops, at which point thetop cover engaging teeth 2404 will abut against the notch 2403 of rotorrings 2402.

4. Smart key 2002 computing system 2709 uses feedback from sensors 2706,2707 to recognize that the rotors 2209 are in a rotational position nearthe top cover engaging teeth 2404 that is sufficient to enable eachnotch 2403 (in its respective unlocked position) to engage with thecorresponding tooth 2404 of the wall 2208, and in response to thissignal slowly rotates rotors 2209, such that notches 2403 engage withteeth 2404 and cause smart key 2002 to rotate past these top coverengaging teeth 2404.

5. The user continues to rotate smart key 2002 until it stops rotating,at which point rotor rings 2402 will be pressing up against the nextpair of engaging teeth 2404, which is a rotational distance sufficientto expose a single slot 2203 of medicine.

6. The user accesses their dose of medication.

7. Smart key 2002 updates its data store to record the date and time ofthis unlock operation of pill box 2001, which may be associated with anidentifier of pill box 2001, such as read from the machine-readableindicia 2003.

Those skilled in the art will recognize that the present invention hasmany applications, may be implemented in various manners and, as such isnot to be limited by the foregoing embodiments and examples. Any numberof the features of the different embodiments described herein may becombined into a single embodiment, the locations of particular elementscan be altered and alternate embodiments having fewer than or more thanall of the features herein described are possible. Functionality mayalso be, in whole or in part, distributed among multiple components, inmanners now known or to become known.

It will be appreciated by those skilled in the art that changes could bemade to the embodiments described above without departing from the broadinventive concept thereof. For example, the above embodiments arediscussed with respect to optical readers and optically-readableindicia. It will be appreciated, however, that other forms of readersand machine-readable indicia can be used, such as radio-frequencyidentification (RFID) readers in combination with RFID tags, magneticreaders in combination with magnetically-encoded media, or the like. Itis understood, therefore, that this invention is not limited to theparticular embodiments disclosed, but it is intended to covermodifications within the spirit and scope of the present invention.While there has been shown and described fundamental features of theinvention as applied to being exemplary embodiments thereof, it will beunderstood that omissions and substitutions and changes in the form anddetails of the disclosed invention may be made by those skilled in theart without departing from the spirit of the invention. Moreover, thescope of the present invention covers conventionally known, futuredeveloped variations and modifications to the components describedherein as would be understood by those skilled in the art.

What is claimed is:
 1. A system for controlling access to a medication,the system comprising a container for the medication, the containercomprising: a casing comprising a top cover having at least one window,the casing further comprising a dispensing opening; a rotating lockmechanism comprising at least a top rotor disposed at least partiallyunder the top cover, the top rotor comprising machine-readable indiciaused to unlock the rotating lock mechanism and selectively accessiblethrough the window when the top rotor is rotated; and a dispensingdevice actuated by the top rotor when the rotating lock mechanism is inan unlocked state, the dispensing device coupled to the dispensingopening, the dispensing device comprising a first carousel, the firstcarousel comprising a plurality of wells, each well configured to retaina respective amount of the medication, actuation of the dispensingdevice causing the first carousel to advance a first predeterminedamount to cause medication stored in at least one of the wells to beobtainable from the dispensing exit.
 2. The system of claim 1 furthercomprising a second carousel disposed under the first carousel, thefirst carousel comprising a first surface to engage with a secondsurface on the second carousel to cause the second carousel to advanceby the first predetermined amount after the first carousel has advancedby a second predetermined amount.
 3. The system of claim 2 wherein thesecond predetermined amount is a full rotation of the first carouselwithin the casing.
 4. The system of claim 1 wherein the rotating lock isa combination lock comprising a bottom rotor and at least oneintermediate rotor between the top rotor and the bottom rotor, each ofthe top rotor, bottom rotor and intermediate rotor comprising a slotconfigured to engage with a connecting arm when in the unlocked state,the connecting arm being driven by the top rotor to correspondinglydrive the bottom rotor, and the dispensing device being actuated by thetop rotor via the bottom rotor.
 5. The system of claim 1 furthercomprising an electronic key engagable with the top rotor, theelectronic key comprising: a computing system; a reader in communicationwith the computing system to provide to the computing system data basedon the machine-readable indicia; and a motor controllable by thecomputing system, the motor comprising a shaft configured tomechanically engage with the top rotor to rotate the top rotor; whereinthe reader is positioned with respect to the shaft of the motor so thatwhen the shaft of the motor is engaged with the top rotor, the readerreads the machine-readable indicia on the top rotor through the windowin the top cover to provide data to the computing system; and whereinthe computing system comprises a processor and memory coupled to theprocessor, the memory comprising dispensing data and program code, theprogram code executable by the processor to cause the processor to:determine if the medication is to be dispensed to a patient according tothe dispensing data; control the motor to unlock the rotating lockmechanism according to the machine-readable indicia and to actuate thedispensing device; and update the dispensing data.
 6. A system forcontrolling access to a medication, the system comprising a containerfor the medication, the container comprising: a casing comprising atleast one rotor providing a locking mechanism to lock or unlock rotationof a rotatable wheel; and a dispensing device actuated by rotation ofthe rotatable wheel, the dispensing device coupled to a dispensingopening in the casing, the dispensing device comprising a carousel, thecarousel comprising a plurality of wells, each well used to contain arespective amount of the medication, actuation of the dispensing devicecausing the carousel to advance a predetermined amount so thatmedication stored in at least one of the wells is obtainable from thedispensing opening.
 7. The system of claim 6 wherein the rotor comprisesa plurality of machine-readable information corresponding to respectiverotational positions of the rotor.
 8. The system of claim 6 furthercomprising an electronic key engagable with the at least one rotor, theelectronic key comprising: a computing system; at least one readerconnected to the computing system to provide to the computing systemrotation data based on the machine-readable indicia obtained from therotor; and at least one motor controllable by the computing system, themotor comprising a shaft configured to mechanically engage with therotor to rotate the respective rotor; wherein the reader is positionedwith respect to the shaft of the motor so that when the shaft of themotor is engaged with the rotor, the reader reads the machine-readableindicia on the rotor to provide the rotation data to the computingsystem; and wherein the computing system comprises a processor andmemory coupled to the processor, the memory comprising dispensing dataand program code, the program code executable by the processor to causethe processor to: determine if the medication is to be dispensed to apatient according to the dispensing data; control the motor to unlockthe combination lock according to the rotation data; and update thedispensing data.
 9. The system of claim 6 wherein: the rotatable wheelcomprises a top wheel engaging a bottom wheel, the at least one rotordisposed between and rotatably coupled to the top and bottom wheels, therotatable wheel at least partially surrounded by and rotatably disposedin a wall extending from the top housing, the wall comprising aplurality of teeth to selectively engage the rotor to prevent rotationaladvancing of the rotatable wheel, the rotor comprising a notch to allowthe rotor to rotatably pass by the teeth to allow rotational advancingof the rotatable wheel; and the dispensing mechanism comprises a gearingmechanism coupling the rotatable wheel to the carousel so that rotationof the rotatable wheel causes corresponding rotation of the carousel.10. The system of claim 9 wherein the rotor comprises a core selectivelyengageable with an outer ring so that a rotational position of the corewith respect to the outer ring is changeable, and wherein the notch isdisposed on the outer ring.
 11. The system of claim 9 wherein thecarousel comprises a central opening, the central opening comprising aplurality of teeth, and the gearing mechanism comprises a gear havingteeth configured to engage the teeth of the central opening, the gearcoupled to a post extending from the bottom wheel through the top coversuch that rotation of the bottom wheel causes corresponding rotation ofthe gear, and rotation of the gear causes corresponding rotation of thecarousel.
 12. The system of claim 11 wherein an angular spacing of theplurality of teeth on the wall, a number of teeth on the gear and anumber of teeth on the central opening are collectively configured tocorrespond to an advancement of the carousel by one well when the rotoradvances from a first tooth on the wall to a subsequent tooth on thewall.
 13. The system of claim 9 further comprising an electronic keyengagable with the at least one rotor, the electronic key comprising: acomputing system; at least a reader connected to the computing system toprovide to the computing system data based on machine-readable indiciaobtained from the container; at least one motor controllable by thecomputing system, the motor comprising a shaft configured tomechanically engage with the rotor to rotate the rotor; wherein thecomputing system comprises a processor and memory coupled to theprocessor, the memory comprising dispensing data and program code, theprogram code executable by the processor to cause the processor to:determine if the medication is to be dispensed to a patient according tothe dispensing data; control the motor to rotate the rotor into anunlock position according to the machine-readable indicia; and updatethe dispensing data.
 14. The system of claim 13 wherein the rotor isbiased to return to a predetermined rotational position, and the programcode is further configured to cause the processor to: use themachine-readable indicia to obtain the unlock position; and control themotor to rotate the rotor from the predetermined position to the unlockposition.
 15. The system of claim 14 wherein the key comprises at leasta position sensor to detect a rotation position of the key with respectto the container, and the program code is further configured to causethe processor to, in response to a signal from the position sensor,cause the motor to rotate so that the notch on the rotor engages thefirst tooth on the wall so that the rotor rotates past the first tooth.16. A method for controlling access to a medication, the methodcomprising: obtaining medication in a container that is unlockable by akey and having indicia on the container that is readable by the key;obtaining the key, the key capable of performing an access process tounlock the container; and coupling the key to the container so that thekey unlocks the container according to at least the indicia.
 17. Themethod of claim 16 wherein the key is configured to unlock the containeraccording to indicia on the container and one or more previous unlockingoperations of the container.
 18. A system for controlling access to amedication, the system comprising: a key configured to perform amechanical unlock operation; and a container for holding the medication,the container comprising machine-readable information readable by thekey, the container configured to dispense a dose of the medicationaccording to the mechanical unlock operation performed by the key;wherein the key is configured to read the machine-readable informationand to perform the mechanical unlock operation according to themachine-readable information and to data stored within the key.
 19. Thesystem of claim 18 wherein the data comprises a date, time or both of aprevious unlock operation performed upon the container, and durationinformation between successive unlock operations for the container. 20.The system of claim 19 wherein the key is further configured to updatethe data to reflect a most recent unlock operation on the container. 21.The system of claim 18 wherein the key is configured to obtain the datafrom a remote server based upon the machine-readable information.
 22. Asystem for controlling access to a medication, the system comprising acontainer for the medication, the container comprising: a bottom cover;a carousel rotatably disposed on the bottom cover, the carouselcomprising a plurality of wells disposed around a central opening, thecentral opening comprising a plurality of teeth; a top cover coupled tothe bottom cover, the top cover comprising a wall extending away fromthe bottom cover, an internal surface of the wall comprising a pluralityof spaced engaging teeth; a bottom wheel rotatably disposed within thewall; a post extending from the bottom wheel through the top cover; agear coupled to the post and engaging with the teeth around the centralopening of the carousel; at least one rotor rotatably disposed on thebottom cover, the rotor comprising a notch configured to engage with theengaging teeth; and a top wheel rotatably in relation the wall and overthe rotor, the top wheel comprising at least one opening, the openingcorresponding to a rotational axis of the respective rotor.
 23. Thesystem of claim 22 wherein the container further comprises a snap-fit tocouple the top cover to the bottom cover.
 24. The system of claim 22wherein the rotor comprises a core selectively engaged with an outerring so that a rotational position of the core with respect to the outerring is changeable, and wherein the notch is disposed on the outer ring.25. The system of claim 22 wherein the rotor is biased to return to arespective predetermined rotational position with respect to the topcover.
 26. The system of claim 25 wherein the container furthercomprises machine-readable indicia for identifying the container. 27.The system of claim 26 further comprising an electronic key engagablewith the top wheel and the rotor, the electronic key comprising: acomputing system; at least a reader in communication with the computingsystem to provide to the computing system identifying data based on themachine-readable indicia obtained from the container; at least one motorcontrollable by the computing system, the motor comprising a shaftconfigured to mechanically engage with the rotor through the hole in thetop wheel to rotate the rotor; wherein the computing system comprises aprocessor and memory coupled to the processor, the memory comprisingdispensing data and program code, the program code executable by theprocessor to cause the processor to: determine if the medication is tobe dispensed to a patient according to the dispensing data and theidentifying data; use the identifying data to obtain the unlockposition; control the motor to rotate the rotor into the unlockposition; and update the dispensing data.
 28. The system of claim 27wherein the engaging teeth are equally angularly spaced, the angularspacing of the engaging teeth, a number of teeth on the gear and anumber of teeth on the central opening are collectively configured tocorrespond to an advancement of the carousel by one well when the rotoradvances from a first engaging tooth on the wall to a subsequentengaging tooth on the wall.
 29. The system of claim 27 wherein theelectronic key comprises at least a position sensor to detect a rotationposition of the electronic key with respect to the container, and theprogram code is further configured to cause the processor to, inresponse to a signal from the position sensor, cause the motor to rotateso that the notch on the rotor engages the first engaging so that therotor rotates past the first engaging tooth.